Bays Harold E, Ballantyne Christie M, Braeckman Rene A, Stirtan William G, Doyle Ralph T, Philip Sephy, Soni Paresh N, Juliano Rebecca A
1 Louisville Metabolic and Atherosclerosis Research Center , Louisville, Kentucky.
2 Baylor College of Medicine and the Methodist DeBakey Heart and Vascular Center , Houston, Texas.
Metab Syndr Relat Disord. 2015 Aug;13(6):239-47. doi: 10.1089/met.2014.0137. Epub 2015 Apr 20.
The aim of this analysis was to examine the effects of icosapent ethyl (eicosapentaenoic acid ethyl ester, IPE) on high-sensitivity C-reactive protein (hsCRP) and lipid parameters in patients with metabolic syndrome, with and without stable statin therapy.
This post hoc exploratory analysis evaluated patients with metabolic syndrome treated with IPE 4 grams/day, IPE 2 grams/day, or placebo in phase 3, randomized, placebo-controlled studies entitled: MARINE [triglyceride (TG) levels ≥500 and ≤2000 mg/dL] and ANCHOR [TG levels ≥200 and <500 mg/dL, despite low-density lipoprotein cholesterol (LDL-C) control with stable statin therapy].
Compared with placebo in patients with metabolic syndrome in MARINE (n=204) and ANCHOR (n=645), at the approved dose of 4 grams/day, IPE significantly lowered hsCRP levels 40.0% (P=0.0007) in MARINE and 23.0% (P=0.0003) in ANCHOR. Compared with placebo in MARINE, which included patients with and without statin therapy, IPE 4 grams/day significantly reduced hsCRP levels 78.0% in statin-treated patients (P=0.0035, n=16). Compared with placebo in MARINE, IPE 4 grams/day significantly reduced TG levels (35.0%; P<0.0001), non-high-density lipoprotein cholesterol (non-HDL-C; 19.9%; P<0.0001), and apolipoprotein B levels (ApoB) (9.1%; P=0.0015) without raising LDL-C levels. Compared with placebo in ANCHOR, IPE 4 grams/day significantly reduced TG (21.7%; P<0.0001), non-HDL-C (13.5%; P<0.0001), ApoB (8.8%; P<0.0001), LDL-C (5.2%; P=0.0236), and HDL-C levels (4.0%; P=0.0053).
Compared with placebo, IPE 4 grams/day significantly lowered hsCRP levels and improved lipids without raising LDL-C levels in patients with metabolic syndrome and high (≥200 and <500 mg/dL) or very high (≥500 and ≤2000 mg/dL) TG levels, with or without stable statin therapy.
本分析旨在研究二十碳五烯酸乙酯(icosapent ethyl,IPE,即二十碳五烯酸乙酯)对代谢综合征患者高敏C反应蛋白(hsCRP)及血脂参数的影响,这些患者接受或未接受稳定的他汀类药物治疗。
这项事后探索性分析评估了在两项3期随机、安慰剂对照研究中接受治疗的代谢综合征患者,这两项研究分别为MARINE [甘油三酯(TG)水平≥500且≤2000mg/dL] 和ANCHOR [尽管接受稳定的他汀类药物治疗使低密度脂蛋白胆固醇(LDL-C)得到控制,但TG水平≥200且<500mg/dL]。患者分别接受每天4克IPE、每天2克IPE或安慰剂治疗。
在MARINE(n = 204)和ANCHOR(n = 645)中,与代谢综合征患者的安慰剂相比,在批准剂量每天4克的情况下,IPE在MARINE中使hsCRP水平显著降低40.0%(P = 0.0007),在ANCHOR中降低23.0%(P = 0.0003)。在MARINE中,与安慰剂相比,包括接受和未接受他汀类药物治疗的患者,每天4克IPE使接受他汀类药物治疗的患者hsCRP水平显著降低78.0%(P = 0.0035,n = 16)。在MARINE中,与安慰剂相比,每天4克IPE显著降低TG水平(35.0%;P < 0.0001)、非高密度脂蛋白胆固醇(non-HDL-C;19.9%;P < 0.0001)和载脂蛋白B水平(ApoB)(9.1%;P = 0.0015),而未升高LDL-C水平。在ANCHOR中,与安慰剂相比,每天4克IPE显著降低TG(21.7%;P < 0.0001)、non-HDL-C(13.5%;P < 0.0001)、ApoB(8.8%;P < 0.0001)、LDL-C(5.2%;P = 0.0236)和高密度脂蛋白胆固醇(HDL-C)水平(4.0%;P = 0.0053)。
与安慰剂相比,对于代谢综合征且TG水平高(≥200且<500mg/dL)或非常高(≥500且≤2000mg/dL)的患者,无论是否接受稳定的他汀类药物治疗,每天4克IPE均可显著降低hsCRP水平并改善血脂,且不升高LDL-C水平。